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Objective To investigate the effect of afferent blockade of visceral adipose tissue(VAT)on cardiac function and cardiac neural remodeling in rats after myocardial infarction(MI).Methods After 30 healthy SPF-grade male SD rats were subjected,12 of them were randomly divided into control group(n=6)and activation group(n=6).In the activation group,low-dose capsaicin(1 mmol/L)was used to activate VAT afferent nerves,while in the control group,an equal amount of normal saline was injected,and real-time blood pressure and heart rate were monitored for 30 min.The other 18 rats were randomly assigned into sham group(n=6),MI group(n=6),and high-dose capsaicin blockade group(n=6).The MI model was established by ligating the left anterior descending coronary artery.After MI modeling,the high-dose capsaicin blockade group was give 33 mmol/L capsaicin to block VAT afferent nerve,and the sham opera-tion group and MI group were injected with the same amount of normal saline.After 2 weeks,car-diac function was measured by echocardiography,infarct size was measured by TTC staining,heart rate variability was analyzed,and myocardial tyrosine hydroxylase(TH)was measured.The levels of myocardial superoxide dismutase(SOD)and malondialdehyde(MDA)were measured by biochemical methods.Results More significant changes in blood pressure and heart rate were observed in the activation group than the control group(P＜0.01).The MI group had obviously larger infarct size,higher LVEDD and LVESD,and increased myocardial TH density and MDA level,but lower LVEF and myocardial SOD activity than the sham group(P＜0.05).However,the infarct size,LVEDD(9.15±0.37 mm vs 10.1±0.85 mm),LVESD(6.33±0.40 mm vs 7.87±0.86 mm)were obviously decreased,while LVEF[(67.04±3.34)％vs(47.10±3.89)％]and myocar-dial FS[(33.26±2.50)％vs(20.81±2.14)％]activity were greatly increased in the high dose capsaicin group than the MI group(P＜0.05).Conclusion Activation of VAT afferent nerve can increase blood pressure and heart rate;while its blockade can reduce the infarct size,protect cardiac function and inhibit cardiac nerve remodeling in MI rats,possibly by reducing oxidative stress.
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With the development of more and more multi-center and cross-field cooperative medical research，the establishment of high-quality and efficient ethical collaborative review and mutual recognition systems is an inevitable demand for multi-institutional research，and an inevitable move to implement relevant national policies.Based on the work practice of ethical collaborative review and mutual recognition in Shenzhen，by analyzing the practical challenges of ethical collaborative review and mutual recognition in China，this paper proposed that to ensure the homogeneity and efficiency of review.Government departments need to take the lead，establish an ethical review alliance，and clarify responsibilities and rights.Based on actual needs，system first，and effective communication，ethical collaborative review and mutual recognition of results could be jointly promoted，aiming to provide a reference for our counterparts in China to promote ethical collaborative review and mutual recognition of cross-institutional research.
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Objective To retrospectively analyze the prevention and control effect and epidemic characteristics of elderly tuberculosis in Hubei Province from 2016 to 2020, and to provide a scientific basis for the prevention and treatment of elderly tuberculosis in Hubei Province． Methods The data on tuberculosis patients aged 60 and above who registered their current address in Hubei Province from 2016 to 2020 were collected and analyzed. The registration rates and composition ratios were analyzed using χ2 test and χ2 test for trend. Results A total of 135 976 tuberculosis patients were reported in Hubei from 2016 to 2020. The annual average registration rate of elderly tuberculosis among the elderly registered residence population (referring to the registration rate of elderly registered residence population aged 60 and above as the denominator, and tuberculosis patients aged 60 and above as the numerator) was 263.51/100 000. The highest rate was 300.02/100,000 in 2017, and the lowest was 188.19/100,000 in 2020 (χ2=70,227.603, P2trend=40.448，P2trend=740.911, P2trend=380.557, P2trend=323.764, P<0.001). Conclusion The elderly population with pulmonary tuberculosis in Hubei Province shows a downward trend. It is necessary to focus on the efforts of designated hospitals to proactively identify cases, increase the proportion of confirmed cases, maintain a high tracking in place, reduce medical delays, and ensure the effectiveness of tuberculosis prevention and treatment for the elderly.
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OBJECTIVE: To investigate the expression of insulin-like growth factor binding protein-3(IGFBP-3) in HELLP syndrome and its possible role in the pathogenesis of this disease. METHODS: 1) 87 subjects were enrolled, including 29 patients with HELLP syndrome, 29 patients with pre-eclampsia (PE), and 29 healthy gravidae as control. The levels of IGFBP-3, IGF-1, TGF-ß1, and VEGF in maternal and umbilical blood of them were detected using ELISA. Correlation analysis was used to observe the correlation between IGFBP-3 and IGF-1/TGF-ß1/VEGF in maternal and umbilical blood, as well as that between maternal serum IGFBP-3 and clinical diagnostic indicators of HELLP syndrome. 2) Human hepatic sinusoid endothelial cells (HLSEC) and human umbilical vein endothelial cells (HUVEC) were cultured with different concentrations of IGFBP-3. After 72 h of culture, cell apoptosis and the normal living cells rate were detected and compared. RESULTS: 1) In both maternal and umbilical blood of HELLP group, levels of IGFBP-3 and TGF-ß1 were higher than control and PE group, IGF-1was lower than control group, VEGF was lower than control and PE group. IGFBP-3 in maternal blood was correlated with IGF-1/TGF-ß1/ VEGF, while IGFBP-3 in umbilical blood was linked to IGF-1/TGF-ß1. In maternal blood, there was a negative correlation between PLT and IGFBP-3, and a positive correlation between ALT/AST/LDH and IGFBP-3. 2) After cultured with IGFBP-3, the total apoptosis rate of either HLSEC or HUVEC was considerably elevated, while the normal living rate was decreased. CONCLUSION: The expression of IGFBP-3 is elevated in HELLP syndrome, which may subsequently promote cell apoptosis by affecting the expression and function of IGF-1, VEGF, and TGFß1 in the IGF/PI3K/Akt, TGF-ß1/Smad3, and VEGF/eNOS/NO pathways. IGFBP-3 aggravates inflammatory reactions of the vascular endothelium and liver under hypoxia, affects the normal function of cells, and plays a role in the pathogenesis of diseases.
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HELLP Syndrome , Insulin-Like Growth Factor Binding Protein 3 , Female , Humans , Endothelial Cells/metabolism , Insulin-Like Growth Factor Binding Protein 3/metabolism , Insulin-Like Growth Factor I/metabolism , Phosphatidylinositol 3-Kinases/metabolism , Transforming Growth Factor beta1 , Vascular Endothelial Growth Factor AABSTRACT
Objective:To investigate the risk factors for bleeding and thrombosis during extracorporeal membrane oxygenation (ECMO) therapy in critically ill patients and determine the best predictors of coagulation-related complications.Methods:A retrospective analysis was performed on patients who received ECMO for respiratory or circulatory failure at Xiangya Hospital of Central South University from January 2020 to December 2022. The outcome was whether bleeding or thrombosis occurred from 24 h after ECMO insertion to before weaning. The differences in demographic characteristics, weaning conditions, prognosis, routine blood tests, organ function, coagulation and blood product transfusion of each group were compared. Logistic regression analysis was used to evaluate the risk factors for bleeding and thrombosis, and ROC curve evaluation was used to assess their capacity to predict complications.Results:A total of 61 patients with ECMO were enrolled, with 21 cases of bleeding and 14 cases of thrombosis during ECMO. Compared with the nonbleeding group, the activated partial thromboplastin time, thromboplastin time (TT), and transfusions of frozen plasma and red blood cells were higher in the bleeding group (all P<0.05). Compared with the nonthrombotic group, the increase in body weight, D-dimer (DD), fibrinogen degradation product (FDP), and improvement of arterial oxygen partial pressure (ΔPO 2) within 24 h were significantly higher in the thrombotic group (all P<0.05). Logistic regression analysis revealed that TT ( OR=1.039, 95% CI: 1.006~1.072, P=0.018) and frozen plasma transfusion volume ( OR=1.046, 95% CI: 1.010-1.083, P=0.012) were risk factors for bleeding events. FDP ( OR=1.030, 95% CI: 1.009-1.051, P=0.005), DD ( OR=1.181, 95% CI: 1.044-1.336, P=0.008), and ΔPO 2 ( OR=1.007, 95% CI: 1.002-1.012, P=0.006) were risk factors for thrombosis. According to ROC curve analysis, the AUCs of TT, frozen plasma transfusion, and combined indexes for predicting bleeding were 0.712, 0.690, and 0.816, respectively. The combined indices had a cut-off value of 0.273, a sensitivity of 75.61%, and a specificity of 80.00%. The AUCs of FDP, DD, ΔPO 2, and combined FDP with ΔPO 2 for predicting thrombosis were 0.778, 0.748, 0.786, and 0.868, respectively. The cut-off value of the combined index was 0.157, the sensitivity was 68.09%, and the specificity was 92.86%. Conclusions:TT combined with frozen plasma transfusion volume predicted bleeding optimally, while FDP plus ΔPO 2 predicted thrombotic events better during ECMO treatment in critically ill patients.
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Objective A HPLC fingerprint method of Alpiniae Oxyphyllae Fructus(AOF)before and after salt-processing was established,to compare the differences of chemical components between raw and processed AOF combined with chemical pattern recognition.Methods HPLC method was used to establish the fingerprint of raw and salt-processed AOF.Principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)were applied to explore the different components of raw and salt-processed AOF in different batches.Results Totally 30 and 32 common peaks in the HPLC fingerprint from the raw and salt-processed AOF were detected,respectively.And 8 of them were identified by comparison with the standards.They were peak X2(5-hydroxymethylfurfural),peak 1(protocatechuic acid),peak 2(protocatechualdehyde),peak 4(epicatechin),peak 21(chrysin),peak 22(kaempferide),peak 25(tectochrysin)and peak 26(nootkatone).The results of PCA and OPLS-DA showed that raw and salt-processed AOF can be grouped into two categories.A total of 12 components,which were considered as differential markers of raw and salt-processed AOF,were screened by method of variable importance in projection(VIP).The 12 components were peak X1,peak 26(nootkatone),peak 16,peak 3,peak X2(5-hydroxymethylfurfural),peak 25(tectochrysin),peak 15,peak 12,peak 8,peak 10,peak 17 and peak 20.Conclusion The combination of HPLC fingerprint and chemical pattern recognition can be used to analyze the quality differences of AOF before and after salt-processing.
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Objective:To explore the lung protective effect of nebulized inhalation of lidocaine (NL) on elderly patients undergoing hip fracture surgery.Methods:A prospective study was conducted on 80 elderly patients who underwent hip fracture surgery at the Huizhou Sixth People′s Hospital from September 2020 to December 2021. They were randomly divided into an NL group and a control group with 40 patients in each group. Within 30 minutes before the start of anesthesia, the NL group was given 2% lidocaine 10 ml oxygen driven nebulization inhalation, while the control group was given equal volume sterile injection water nebulization inhalation. All patients underwent general anesthesia with laryngeal mask intubation and iliac fascia space block. A randomized, double-blind, and controlled clinical study was conducted. The average values of intraoperative peak airway pressure (P peak), plateau airway pressure (P plat), and lung dynamic compliance (C dyn) were compared between two groups of patients; We compared the changes in arterial partial pressure of CO 2 (PaCO 2), alveolar arterial oxygen differential pressure (A-aDO 2), respiratory index (RI), and oxygen index (OI) between the two groups of patients and before and after surgery; The clinical pulmonary infection score (CPIS) and lung ultrasound score (LUS) were also compared between two groups of patients on the first day before surgery, the second day after surgery, and the seventh day after surgery. Resultsl:There was no statistically significant difference in the average values of P peak, P plat, and C dyn between the two groups during surgery (all P>0.05). After surgery, A-aDO 2 and RI in both groups increased compared to before surgery, while OI decreased compared to before surgery (all P<0.05); After surgery, A-aDO 2 and RI in the NL group decreased compared to the control group, while OI increased compared to the control group (all P<0.05); There was no statistically significant difference in PaCO 2 between the two groups before and after skin incision (all P>0.05). Compared with the 1st day before surgery, the CPIS and LUS in both groups were significantly increased on the 2nd and 7th day after surgery (all P<0.05); Compared with the second day after surgery, the CPIS and LUS of both groups of patients were significantly reduced on the seventh day after surgery (all P<0.05); On the second day after surgery, the CPIS and LUS in the NL group were significantly lower than those in the control group (all P<0.05); On the 7th day after surgery, the LUS of the NL group was significantly lower than that of the control group ( P<0.05); There was no statistically significant difference in CPIS scores between the two groups ( P>0.05). Conclusions:Nebulized inhalation of lidocaine can reduce lung function damage in elderly patients undergoing hip fracture surgery, and has a certain lung protective effect.
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BACKGROUND: The Shuangshen Pingfei formula (SSPF), a classic Chinese medicine derivative formula, has been shown to exert therapeutic effects on idiopathic pulmonary fibrosis (IPF). However, the quality control compounds of SSPF remain unclear. PURPOSE: To select and confirm Q-markers of SSPF based on network pharmacology, cytobiology, animal-based pharmacodynamics, and phytochemical and pharmacokinetic analyses. METHODS: A compound-target network was constructed based on previous research. In addition, high-degree compounds of SSPF were chosen as potential Q-marker candidates. Animal and cytological experiments were performed to verify key targets of IPF. Haematoxylin-eosin and Masson's trichrome staining were used to observe lung tissue pathology. Cytokine levels in the bronchoalveolar lavage fluid (BALF) were measured using ELISA kits. Gene and protein expression levels were determined using PCR and western blotting, respectively. The contents of Q-marker candidates in different batches of SSPF were then determined for traceability research, and the quality consistency of SSPF was objectively evaluated using principal component analysis (PCA). Finally, pharmacokinetic research was performed, and candidates with desirable metabolite and bioavailability parameters were confirmed as Q-markers of SSPF. RESULTS: The compound-target network included 56 compounds and 14 therapeutic targets. Animal experiments showed that SSPF attenuates lung fibrosis. SSPF decreased CC motif chemokine 2 (CCL2) and CC chemokine receptor type 2 (CCR2) levels in the BALF and downregulated the gene and protein expression of IPF therapy-related molecules, such as 5-hydroxytryptamine receptor 2A (HTR2A), CCL2, and CCR2, in the lungs. Cell experiments showed that nine Q-marker candidates in SSPF regulated the expression of CCL2 and CCR2, as predicted. Phytochemical analysis and PCA indicated that the qualities of SSPF in the nine batches were relatively stable. Pharmacokinetic studies demonstrated that mangiferin, salvianolic acid B, tanshinone IIA, naringin, and glycyrrhizic acid could be effectively absorbed into rat plasma, which ensured desirable bioavailability and confirmed their roles as Q-markers to represent anti-pulmonary fibrotic activity. CONCLUSION: Our study is an integrated strategy, based on network pharmacology with experimental verification and phytochemical and pharmacokinetic analyses that provides a novel approach for Q-marker selection and validation of SSPF for IPF treatment.
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Drugs, Chinese Herbal , Idiopathic Pulmonary Fibrosis , Animals , Biomarkers , Drugs, Chinese Herbal/chemistry , Idiopathic Pulmonary Fibrosis/drug therapy , Network Pharmacology , Phytochemicals/pharmacology , RatsABSTRACT
Objective:To investigate the efficacy of compound Lactobacillus acidophilus tablets combined with bismuth-containing quadruple therapy in the treatment of Helicobacter pylori-positive (Hp +) chronic non-atrophic gastritis and its effect on Lactobacillus and Escherichia coli.Methods:A total of 104 patients with Hp + chronic non-atrophic gastritis who received treatment in Affiliated Hospital of Shaoxing University from March 2019 to September 2020 were included in this study. They were randomly divided into control and observation groups, with 52 patients in each group. The control group was treated with bismuth-containing quadruple therapy. The observation group was treated with compound Lactobacillus acidophilus tablets (2 tablets once, three times per day) based on bismuth-containing quadruple therapy. Two groups were treated for 2 successive weeks. The endoscopic grading score of gastric mucosa, improvement in pathological grading of gastric mucosa, Hp eradication rate, and Lactobacillus and Escherichia coli levels were compared between the two groups. Results:After treatment, endoscopic grading score of gastric mucosa (gastric mucosa inflammation, inflammation activity, atrophy, and intestinal metaplasia) in the observation group was (1.31 ± 0.18) points, (1.24 ± 0.18) points, (1.15 ± 0.16) points, (1.04 ± 0.15) points, respectively, which was superior to (1.73 ± 0.25) points, (1.59 ± 0.21) points, (1.44 ± 0.19) points, (1.30 ± 0.18) points in the control group ( t = 3.67, 3.80, 4.17, 4.52, all P < 0.01). Improvement in pathological grading of gastric mucosa in the observation group was significantly higher than that in the control group [94.23% (49/52) vs. 78.85% (41/52), χ2 = 4.04, P < 0.05]. Hp eradication rate in the observation group was significantly higher than that in the control group [92.31% (48/52) vs. 75.00% (39/52), χ2 = 4.50, P < 0.05]. After treatment, the amount of Lactobacillus and Escherichia coli in the observation group were (8.30 ± 0.95) copies and (8.04 ± 0.95) copies, which were significantly greater than (7.51 ± 0.93) copies and (8.30 ± 0.95) copies in the control group ( t = 4.02, 3.75, both P < 0.01). Conclusion:Compound Lactobacillus acidophilus tablets combined with bismuth-containing quadruple therapy is highly effective on Hp + chronic non-atrophic gastritis and it can effectively improve intestinal microflora.
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Mori Cortex is sweet and pungent in taste， cold in nature， and has the tropism to the lung meridian. It has the functions of purging the lung and relieving asthma and can treat oliguria and edema， being one of the commonly used herbal medicines in clinical practice. The prescriptions with Mori Cortex， such as Sangbaipi Tang， Qingjin Huatanfang， and Qingfei Huatantang， are widely used in clinical practice. The main active components in Mori Cortex are the material basis for its efficacy. Owing to the mature methods for the identification of pharmacodynamic substances in Chinese herbal medicines， the research on the chemical components of Mori Cortex has been in-depth and systematic. This article reviews the recent studies about the chemical components and pharmacological effects of Mori Cortex， as well as the treatment of respiratory diseases by the prescriptions with Mori Cortex. On this basis， the effect and mechanism of Mori Cortex and related prescriptions in the treatment of respiratory diseases are summarized. Furthermore， this article analyzes the formulation compatibility and commonly used dosages of Mori Cortex-related prescriptions in clinical practice. It provides reference for the clinical application of Mori Cortex and related prescriptions in the treatment of respiratory diseases.
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Mori Cortex is sweet and pungent in taste， cold in nature， and has the tropism to the lung meridian. It has the functions of purging the lung and relieving asthma and can treat oliguria and edema， being one of the commonly used herbal medicines in clinical practice. The prescriptions with Mori Cortex， such as Sangbaipi Tang， Qingjin Huatanfang， and Qingfei Huatantang， are widely used in clinical practice. The main active components in Mori Cortex are the material basis for its efficacy. Owing to the mature methods for the identification of pharmacodynamic substances in Chinese herbal medicines， the research on the chemical components of Mori Cortex has been in-depth and systematic. This article reviews the recent studies about the chemical components and pharmacological effects of Mori Cortex， as well as the treatment of respiratory diseases by the prescriptions with Mori Cortex. On this basis， the effect and mechanism of Mori Cortex and related prescriptions in the treatment of respiratory diseases are summarized. Furthermore， this article analyzes the formulation compatibility and commonly used dosages of Mori Cortex-related prescriptions in clinical practice. It provides reference for the clinical application of Mori Cortex and related prescriptions in the treatment of respiratory diseases.
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At present, discipline construction has gradually become the core theme of the development of clinical pharmacy in hospitals. As a key construction project unit of clinical pharmacy in Shanghai, from August 2017 to October 2019, the Obstetrics and Gynecology Hospital of Fudan University continued to promote the clinical pharmacy from four aspects: improving the practical ability of clinical pharmacists, building the information and automatic clinical pharmaceutical service mode, establishing the talent training echelon and promotion system, and strengthening the capacity of clinical transformation research and construction.
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Objective To analyze the treatment outcomes of multidrug-resistant pulmonary tuberculosis (MDR-TB) cases in Hubei Province. Methods From October 2006 to June 2017, a retrospective cohort analysis of treatment outcomes for 1 447 patients with MDR-TB who were included in treatment was performed. Excel worksheet was created to establish database by monthly and quarterly reports. The statistical analysis of data was conducted using SPSS 21.0 software. Results Among 1 447 MDR-TB patients, 1 076 were males and 371 were females, with an average age of 44.44±14.28 years. 798 patients were cured, 63 patients completed the course of treatment, and the overall treatment success rate was 59.50% (861/1 447). The treatment success rate was68.02% (268/394) in newly diagnosed cases, and 56.32% (593/1 053) in relapse cases. There was a significance difference between the two groups (χ2=16.30，P2=26.65，P2=1.34，P=0.25). Conclusion It is extremely important to screen drug-resistant individuals for smear-positive patients, and to detect and treat drug-resistant patients timely. The negative conversion of sputum bacteria at the end of 6th month had important predictive significance for the treatment outcomes of MDR-TB patients. The patients with continued positive sputum at the end of 6th month should be closely monitored to adjust treatment according to the progress of the patient's condition and to explore a way to shorten the treatment course.
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0bjective To translate and revise the Assessment of Interprofessional Team Collaboration Scale (AITCS) into Chinese, then to evaluate the reliability and validity of the Chinese version of AITCS. Methods The Chinese version of AITCS was translated from the original one, back-translated and adjusted for cultural adaptation. The reliability and validity were tested among 288 nurses, 81 physicians, 25 respiratory therapists, 10 physical therapists and 3 nutritionists from a tertiary hospital in Hangzhou using convenience sampling. Results The average of scale-level content validity index was 0.98, unanimity of scale-level content validity index was 0.84 and item-level content validity index was 0.89-1.00. Exploratory factor analysis extracted three common factors,which explained 61.427% of the total variance,and each item had high factor loading quality (>0.4). The correlations coefficients between each dimension score and the total score ranged from 0.801 to 0.898 (P<0.05),and the correlations coefficients between each dimension score ranged from 0.607 to 0.698 (P<0.05). The Cronbach α of AITCS was 0.909, split-half reliability was 0.835 and test-retest reliability was 0.763. Conclusion The Chinese version of the AITCS has been proved to be reliable and valid. It is a valuable tool for evaluating interprofessional team collaboration among the health professional providers in mainland China.
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Objective To probe into the status of " Internet +maternal and children healthcare"services provided by municipal maternal and child healthcare institutions, and to analyze existing problems, provide reference for the development of " Internet+maternal and children healthcare" for MCH institutions and other medical institutions. Methods From June to August 2018, the National General Information Platform on Women and Children Health was engaged, to launch a questionnaire survey on the status of" Internet+maternal and children healthcare" application at municipal MCH institutions across the country. Results The top three handy services for the public provided by municipal MCH institutions using the" Internet+" technology for the clients were hospital information inquiry, appointment registration and medical test result queries, accounting for 49.1% , 44.2% and 35.8% respectively. The proportion of" Internet+" specific service for women and children from high to low were portable device remote monitoring ( 16.1% ), antenatal examination/physical examination of children/vaccination reminder (13.3% ), online school for pregnant women(10.2% ), follow-up management services(9.8% ) and self-service measurements such as body height, weight, and blood pressure(3.5% ).The top three services for doctors were patient test result checkup, inquiry of patients′ basic information, and inquiry of patients′treatment, accounting for 19.3% , 17.5% and 13.0% respectively.In terms of service provision of the top one service for nurses was specimen code scan(17.5% ).In terms of the 18 handy services accessible, 5 specific services for women and children, 9 services for doctors, 4 services for nurses, the proportion declined in turn from the eastern, central and western areas in the country.The top three roadblocks to be resolved right away in the " Internet+maternal and children healthcare" service, were the lack of supervision system, that of professional technical management personnel and that of standard specifications, accounting for 63.5% , 57.5% and 49.1% respectively. Conclusions The " Internet+maternal and children healthcare"in municipal MCH institutions in China stays at an initial development stage, and there is a great development difference between the eastern, central and western regions of China. Relevant measures must be taken to reduce the development gap between municipal MCH institutions among these regions, and to solve the roadblocks curbing the development of " Internet + maternal and children healthcare" in municipal MCH institutions in China.
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Objective To investigate the fatigue status and influencing factors of nurses,and to evaluate whether trait coping styles mediate the relationship between occupational stress and fatigue.Methods A total of 167 nurses in Shaoxing Municipal Hospital were selected by cluster random sampling in April,2018.Their fatigue status was assessed by Chinese version of multidimensional fatigue scale,occupational stress was assessed by occupational stress inventory revised edition,and trait coping style was assessed by trait coping style questionnaire.The data were analyzed by SPSS22.0.Results A total of 164 valid questionnaires were obtained,the physical fatigue score was (22.9 ± 9.3) points,the decreased activity score was (6.7 ± 2.7) points,the decreased motivation score was (6.6 ± 2.6) points,the mental fatigue score was (9.0 ± 4.0) points,the total fatigue score was (47.3 ± 13.5) points.The total fatigue scores of nurses with different ages(F =2.520,P =0.043),nursing years(F =3.388,P =0.020),educational background(t =-2.571,P =0.011),professional tide (F =3.743,P =0.026),departments (F =4.412,P =0.001) and night shift frequency (F =3.412,P =0.019) were significantly different.The total fatigue scores were positively correlated with negative coping (r =0.274,P =0.009),occupational tasks (r =0.351,P =0.007) and stress response (r =0.348,P =0.004) respectively.Negative coping styles partially mediated the relationship between occupational stress and fatigue.The total effect of occupational stress on fatigue was 0.066,the ratio of negative coping to total effect was 49.62％.Conclusion There are many factors influencing nurses'fatigue,and negative coping styles play a mediating role between occupational stress and fatigue.
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Objective@#To investigate the fatigue status and influencing factors of nurses, and to evaluate whether trait coping styles mediate the relationship between occupational stress and fatigue.@*Methods@#A total of 167 nurses in Shaoxing Municipal Hospital were selected by cluster random sampling in April, 2018.Their fatigue status was assessed by Chinese version of multidimensional fatigue scale, occupational stress was assessed by occupational stress inventory revised edition, and trait coping style was assessed by trait coping style questionnaire.The data were analyzed by SPSS22.0.@*Results@#A total of 164 valid questionnaires were obtained, the physical fatigue score was (22.9±9.3)points, the decreased activity score was (6.7±2.7)points, the decreased motivation score was (6.6±2.6)points, the mental fatigue score was (9.0±4.0)points, the total fatigue score was (47.3±13.5)points.The total fatigue scores of nurses with different ages(F=2.520, P=0.043), nursing years(F=3.388, P=0.020), educational background(t=-2.571, P=0.011), professional title(F=3.743, P=0.026), departments(F=4.412, P=0.001) and night shift frequency(F=3.412, P=0.019) were significantly different.The total fatigue scores were positively correlated with negative coping(r=0.274, P=0.009), occupational tasks(r=0.351, P=0.007) and stress response(r=0.348, P=0.004) respectively.Negative coping styles partially mediated the relationship between occupational stress and fatigue.The total effect of occupational stress on fatigue was 0.066, the ratio of negative coping to total effect was 49.62%.@*Conclusion@#There are many factors influencing nurses' fatigue, and negative coping styles play a mediating role between occupational stress and fatigue.
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Objective@#To investigate the occupation stress and job burnout of orphan child care workers in Nanjing and nursing staff in Yangzhong primary hospital, to compare the differences of occupational stress and job burnout between the two social service workers.@*Methods@#From February to May 2017, a cross- sectional survey was conducted. Cluster sampling method was used to investigate the occupation stress and job burnout of orphan child care workers in Nanjing and nursing staff in Yangzhong primary hospital, totally 403 people, by a combination of the Internet of things assessment system of occupational stress and traditional questionnaire.@*Results@#There were statistically significant differences of occupational stress and job burnout scores of both social service workers (P<0.05). Orphan child care workers in job control, technology utilization, job routinization, work risk, role ambiguity and participation decision-making, anxiety state, body complain, life attitude, behavior characteristics, ambition, anxiety trait, social support, logic, family-work relationship and depersonalization were higher than those of Yangzhong primary nurses (P<0.05); Primary nurses in Yangzhong in quantitative load and change, workload, role conflict, job prospects, promotion, depressive symptom, daily stress, self-esteem, task strategy, time management, work input, and personal accomplishment reduction scored higher than those of Orphan child care workers (P<0.05). The logistic regression analysis of the occupational depletion positive rate of the two social service personnel showed that the protective factors of the nursing staff of the orphans and disabled children had behavioral characteristics and family support(OR=0.877, P=0.044; OR=0.691, P=0.001) . The contributing factors of the primary nursing staff in Yangzhong were task control, workload, work psychological control source (OR=1.110, P=0.019; OR=1.128, P<0.001;OR=1.066, P=0.032) . The protection factors were technical utilization, opportunities for improvement, and mental health (OR=0.775, P=0.005; OR=0.765, P=0.006; OR=0.914, P=0.002) .@*Conclusion@#The work content, the service object and the nature of the unit of primary caregivers influence the state of occupational stress and job burnout. The influencing factors of occupational stress and job burnout are not identical, Different social service personnel show occupational stress and occupational exhaustion in different aspects, and it is necessary to propose mitigation measures for two kinds of social service personnel.
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Objective@#To investigate the clinical effect of the combination of distal subcutaneous buried suture, to reduce local tension, and electron irradiation for the treatment of keloid.@*Methods@#From May 2014 to July 2016, nine female patients with recurrent keloid in torso were treated by above method. After eligibility was confirmed, surgery was performed to completely excise the keloid. An extensive subcutaneous segregation was made around the incision. The 4-0 PDS Ⅱ sutures were buried in the subcutaneous layer, 1.5 cm from the edges of incision, 1 cm apart from each other, and were knotted from both ends of the incision to the center. The normal skin on both sides of the incision were pulled toward the center, and completely relaxed without tension. An interrupted subcutaneous suture was made with a 4-0 Coated VICRYL absorbable suture, and a continuous intradermic suture was made using a 5-0 Coated VICRYL absorbable suture. Superficial electron irradiation was implemented 10-22 h postoperatively. The dose of radiation was 4 Gy each time, with the frequency of 4-5 times in 4-7 days, once a day, and the total dose was up to 16-20 Gy.@*Results@#The average follow-up was 15 months (12-18 months). Based on the three-stage classification system formulated by Dr. Cai, an asymptomatic flat and soft scar without recurrence up to 12 months was classified as cured (excellent). All the patients in this series met the criterion of cure.@*Conclusions@#The distal subcutaneous buried suture technique, pulling bilateral normal skin toward the center with a PDS Ⅱ suture, could completely relax the skin around the incision, and maintain a prolonged tension-free state, combination therapy of electron irradiation and surgery may reduce the inflammation during the healing process, and result in a dramatic inhibition of the recurrent of keloids after surgery.